Fractioned Stereotactic Radiosurgery in Patients with Paraganglioma

INTRODUCTION: Paraganglioma are rare, indolent and highly vascular tumors. The treatment options for paraganglioma include surgery, conventional external beam radiotherapy (EBRT), stereotactic radio-surgery (SRS) or combination of these modalities. EBRT has been used to treat unresectable tumors and patients with residual or recurrent lesions after surgery
The aim of this study is evaluated the results of treatment in patients with paraganglioma who were treated with fractioned stereotactic radiotherapy

METHODS: Nine patients with paraganglioma, who were treated with fractioned stereotactic radiotherapy, were retrospectively evaluated.Two patient was male, and others were female. The median dose to the tumor was 25 Gy in median 5 fractions
RESULTS: Median follow-up was 65 months (range, 46-71 months). All patients were evaluated with magnetic rezonance imaging, every 6 months. Lesions were stable in 3 patients, and it was observed complete response in 1 patient and partial response in 5 patients. We did not observe any treatment related acute toxicity in our patients. We observed late toxicity in 2 patients.
DISCUSSION AND CONCLUSION: In conclusion, according to our experience, fractioned stereotactic radiotherapy with CyberKnife® (AccurayIncorporated, Sunnyvale, CA) seems to be successful treatment option in the management of paraganglioma.

Paragangliomalý Hastalarda Fraksiyone Stereotaktik Radyoterapi

GÝRÝÞ ve AMAÇ: Paraganglioma, nadir görülen, aðrýsýz, yoðun vasküler yapýya sahip tümördür. Paraganglioma için tedavi seçenekleri, cerrahi, konvansiyonel radyoterapi, stereotaktik radyocerrahi ya da bu modalitelerin kombinasyonudur.
Bu çalýþmanýn amacý, farksiyone stereotaktik radyoterapi ile tedavi edilen paragangliomalý hastalarýn tedavi sonuçlarýný deðerlendirmektir

YÖNTEM ve GEREÇLER: Kliniðimizde tedavi edilen, fraksiyone stereotaktik radyoterapi yöntemi ile tedavi edilen dokuz hasta deðerlendirildi. Ýki hasta kadýn, diðerleri erkekdi. Uygulanan tedavi dozu median 5 fraksiyonda 25 Gy idi.
BULGULAR: Median takip 65 ay (46-71 ay) dý. Hastalarýn tümü tedavi sonrasý 6 ayda bir manyetik rezonans görüntüleme(MRI) ile deðerlendirildi. Lezyonlar 3 hastada stabil iken, 1 hastada tam cevap, diðer beþ hastada parsiyel cevap elde edildi. Hastalarýn hiçbirinde akut toksisite görülmedi. Ýki hastada ise takiplerde geç toksisite görüldü
TARTIÞMA ve SONUÇ: Bizim deneyimlerimize göre, paraganglioma tedavisinde, CyberKnife® (Accuray Incorporated, Sunnyvale, CA) ile fraksiyone stereotaktik radyoterapinin, baþarýlý bir tedavi seçeneði olduðu görülmüþtür.